Hepatitis A beginns acute. In Hepatitis B (serum hepatitis), the disease
is usually more serious. Otherwise, both are similar.

Hepatitis A has an incubation period of 15 to 40 days. Infection is
seldom transmitted through blood or serum.

Hepatitis B has an incubation period of 40 to 160 days and can be
transmitted through blood, nonsterile syringes, or sexual contact.

Course of the Disease

The prodromal stage (two days to three weeks) usually begins with a
rapid rise in body temperature to about 102° F (= 39° C) with chills, headache,
nausea, sometimes vomiting,

generally diarrhea, rarely constipation, and flatulence.

1. Some symptoms are similar to a common cold. There are stomachaches,
loss of appetite, and aversion to alcohol, nicotine, and fried or fatty foods.
There is itchiness and occasionally

a rash. The liver and spleen can be hard and enlarged. Joint and muscle
pains can dominate the picture, making one think of rheuma or arthritis. The
fever often disappears after one or two

days. Occasionally there is a second fever for another couple of days.
In 10 - 20% of the cases there is no fever at all, and one thinks it is simply
an upset stomach.

There is no jaundice in about 50% of all hepatitis cases. Often the
disease is diagnosed as the flu or an intestinal infection and not treated
correctly. For this reason a strong aversion

to fat should make you suspicious.

At the end of the prodromal phase many patients feel healthy and think
the "flu" or their "intestinal infection" is over.

2. But now the jaundice or full phase begins, lasting two to eight
weeks. At first the white of the eyes becomes yellow to yellow-green. The skin
can itch in the evening.

In many cases, the jaundice ends after a few days. The liver remains
enlarged for two to three weeks. The spleen is also enlarged in 20 – 30% of the
cases. In about 25% of the cases

there is bradycardia, an abnormally slow heartbeat.

Because of the presence of bile in the urine, the patient's urine
samples are brown, with yellow foam when shaken. The stools are light and clay
colored; occasionally they may be gray

for a few days. The amount of urine is reduced during this phase.

3. The post-jaundice phase, lasting four weeks, is marked by a sudden
excretion of copious urine. The yellow skin becomes paler, and the appetite
returns. The stools take on a darker color,

and the urine becomes lighter. The intolerance to fatty foods usually
remains. The most dangerous time is at the end of the second phase and the
beginning of the third phase.

The patient often feels so much better that he doesn't follow the
necessary precautions. He wants to eat and live normally. This increases the
danger of a relapse. When there is a relapse,

the jaundice comes on again even more severely, the liver becomes
harder, and the general condition is worse than ever. The relapse usually lasts
longer than the original sickness 3 - 6 months

and more). Relapses can occur even months after recovery.

Various complications of the liver may arise, including chronic
inflammation of the liver, liver cirrhosis, and acute yellow atrophy of the
liver.

Hepatitis can occur in a number of forms:

1. In the abortive form, the patient experiences a few days of jaundice
with minimal complaints.

2. A form without symptoms occurs primarily in children.

The presence of hepatitis can be established only by laboratory tests.
But the absence of jaundice does not mean that the course of the disease has
been a light one.

3. During the malignant form, the jaundice becomes more and more
intense. The liver's toxicity rises, and there is fetor hepaticus (the bad odor
to the breath that is a sign of liver failure),

together with twitching and an increasing clouding of consciousness,
which ends in coma hepaticum. This form occurs primarily in elderly patients
[hepatitis B (serum hepatitis)].

4. The cholestatic form is marked by signs of impedance of the
gallbladder: intense itching, severe jaundice, disappearance of the
urobilinogens from the urine, increase of alkaline phosphatase

and cholesterol. Post-hepatitis syndrome can develop from fear, whereby
the liver is not inflamed. Tiredness, sleeplessness, digestive disturbances,
and an intolerance for fat result.

Rarely, this takes the form of post-hepatic hyperbilirubinemia, with
signs of sub icterus and an increase of the indirect bilirubins in the blood
without bilirubinuria and disturbance of the liver.

Homeopathic Protection

Generally, protection against hepatitis A is enough for tourists.

A double dose of Hepatitis A Nosode C 200 works for about six months.
For those who come in contact with blood or serum infected by hepatitis B
(nurses, doctors, and so forth)

an additional double dose of Hepatitis B Nosode C 200 is recommended.

Nutrition and Care

Bed rest and diet are critical. Depending on the intensity of the
illness and fever, the patient should fast completely or maintain a very light,
fat-free diet. Starchy foods, fat, meat, eggs, and

milk should be completely avoided as long as the jaundice is present.
Especially valuable are sour and sweet-sour fruits and watery vegetables (such
as zucchini, pumpkin, ripe or unripe papaya);

later, fat-free natural yogurt can be introduced. Ripe papaya can be
eaten as a raw fruit, or the unripe fruit may be cooked like a vegetable and
eaten with rice. Other juicy, ripe fruits are also good. Water and herbal teas
are helpful drinks.

Homeopathic Treatment

The basis of homeopathic treatment for hepatitis is not the
classification into virus A or B, but the course the disease is taking.

The symptoms and other signs will tell us what we have to deal with. The
homeopathic treatment of hepatitis is complex and as with all diseases has to
be evaluated individually.

You can help yourself or others with the following two remedies in
simpler cases and when you have no other choice. If the symptoms match closely,
they will help to cure faster; otherwise,

the case will at least be milder.

Chel.: Symptoms indicating this medicine include thirst for warm drinks
+/o. below the right shoulder blade a rising from the liver.

Hepatitis refers to inflammation of the liver,
and is usually but not always the result of a virus. Most of the publicity we
hear these days concerns the spread of Hepatitis C.

In fact hepatitis can be caused by alcohol and
chemicals as well as many different viruses. Most of the cases of viral
hepatitis in Australia are classified as types A, B or C.

Types A and B were discovered over 20 years ago
but type C (HVC) was discovered as recently as 1988. HVC is now considered to
be the most prevalent type in Australia.

Over 1500 cases have been notified in the Hunter
Valley alone, 0x more prevalent than the HIV virus. At least 6 are known
strains of HVC and a mixture of strains may occur

in an infected person.

While it is known that HVC is spread by blood,
through such agents as hypodermic needles, blood transfusions (before 1990) and
through cuts and scratches, almost half infected patients don't know the source
of the infection. The disease is further complicated since carriers can take up
to 20 years before aquiring liver damage, and many cases remain symptomless. In
fact cases of clinically acute hepatitis are relatively rare. The long duration
between infection and illness represents an opportunity for the individual to
seek alternative or complementary treatments, and to adopt lifestyle and
dietary changes which will enhance liver performance and overall health status.

Whatever the cause of the hepatitis its
treatment will follow similar principles, whichever system of medicine is used.
In many Asian countries there have been treatments available within their
traditional healing systems for centuries. TCM and Ayurvedic pharmacopoeias
contain numerous references to specific medicines and formulas, usually used in
conjunction with other techniques such as acupuncture and dietary therapy.
Presently a clinical trial is underway using a Chinese herbal formula with HVC
patients at the John Hunter Hospital, Newcastle, under its director of
gastroenterology Professor Bob Batey. The results are eagerly awaited. When it
comes to western medicine there is very little on offer for hepatitis
sufferers, apart from blood tests and biopsies. The only treatment available is
interferon, which is very expensive (up to $5000 for a course), ineffective in
many cases, and has possible side effects including headaches, depression and
flu-like symptoms.

This article reviews the treatment of hepatitis
using western, Chinese and Ayurvedic herbs, and offers some dietary advice and
sources of support and information about this much feared and misunderstood
condition.

PRINCIPLES FOR TREATMENT OF LIVER DISORDERS.

The liver is clearly one of the largest and most
important organs in our bodies, and it is not suprising therefore that
inflammation of the organ can lead to numerous unpleasant symptoms and loss of
vitality. In the long term it can cause liver cirrhosis and death. However most
carriers of the disease will experience less severe symptoms including pain
around the liver, nausea, anorexia and fatigue. Digestion of fats is impaired
and alcohol cannot be tolerated. The first indication is often jaundiced skin
and dark urine- these signs can be confirmed by a blood test that measures
levels of the enzyme ALT (alanine aminotransferase) which are elevated in acute
hepatitis, but are often normal in chronic cases. Blood tests also reveal the
presence of antibodies to specific viruses. Any person suspecting they may have
hepatitis should immediately seek a medical diagnosis- the earlier the
detection of the disease the more successful subsequent treatment is likely to
be.

The presence of blood abnormalities, ie. raised
liver enzymes and presence of viral anti-bodies, point to two ways in which
herbal treatments can be of assistance.

1th
there are a number of herbal remedies which protect liver cells from damage by
poisons and viruses, and there are ample published reports of animal studies
and clinical trials which have demonstrated an ability of a herb to lower
levels of liver enzymes (including ALT) in affected individuals. Some of these
studies are listed in the bibliography. A medicine with the ability to protect
liver cells in this way is referred to as a hepatoprotective. In a recent
article in the Australian Journal of Medical Herbalism (email:
ajmh.hunterlink.net.au) I identified 26 common herbs for which hepatoprotective
properties have been demonstrated in controlled studies.

2nd
The means by which herbal remedies can be of help is in supporting the immune
systems efforts to fight off the virus. In some cases (eg. Phyllanthus)
specific antiviral properties have been demonstrated. In other cases (eg.
Echinacea) the action is non-specific and involves a boost to the whole immune
system.

It must be pointed out that herbal treatments
are not designed for acute stages of hepatitis. In this case bed rest and low
fat diet, along with gentle herbal diaphoretics such as elderflowers (Sambucus
nigra) and catnip (Nepeta cataria) are the limit of treatment recommended. The
more widespread and longer lasting chronic stages of hepatitis lend themselves
to treatments with herbal remedies and other natural therapies. Herbalists
believe strongly in the need for bitter compounds as food and medicines in order
to stimulate production of gastric juices and bile from the liver. Herbs which
stimulate bile flow are known as choleretics, while those that stimulate
excretion of bile from the gall bladder are known as cholagogues. Many herbs
have both properties and these are extremely useful in correcting digestive
disorders in general, and for helping detoxify the liver in particular. Herbs
with these properties include gentian (Gentiana lutea), wormwood (Artemisia
absinthium) and horehound (Marrubium vulgare). Traditional compounds such as
the well-known Swedish Bitters have similar effects.

I have found the use of herbal decoctions to be of
great assistance in hepatitis cases. Although less concentrated than fluid
extracts and tinctures they have the advantage of being free of alcoholic
solvents, an important consideration in any liver disorder. Some people will
object to the taste, however the bitterness is an important aspect of the
treatment as noted above. Ingestion of herbal tablets and capsules does not
give this effect.

DIETARY PRINCIPLES

There is no doubting the importance of low fat
diets for hepatitis sufferers. One of the main roles of bile (which the liver
manufactures) is to break down fats so the body can absorb them, as well as to
convert fat soluable toxins and wastes into water soluable compounds the body
can eliminate. These functions are severely impaired when the liver is
inflammed so that avoidance of fatty foods is a way of resting the liver. Foods
to be avoided or taken in moderation are full fat dairy protects, fried foods,
red meats and vegetable oils. A dessertspoon of olive oil on a daily basis can
be of benefit so long as it is well tolerated. Its digestibility is assisted by
combining with lemon juice. Protein intake on the other hand is necessary to
assist the liver in the process of cell regeneration. White meats (fish and
chicken) are preferred to red meats for their lower fat content, while
vegetable proteins are best taken in combinations of pulses (beans, peas,
lentils, tofu) with wholgrains such as rice, wheat and barley.

Just as bitter herbs are prescribed to correct
liver sluggishness, so are bitter foods added to the diet to improve digestive
function. Wild greens such as dandelion, plantain and dock leaves can be added
to meals and sandwiches, or cultivated greens such as chicory and endive. In
traditional Asian systems of healing there is also emphasis placed on balancing
the five tastes- sweet, salty, sour, bitter and pungent (hot). It is unwise to
have an excess or deficiency of these flavours in the diet. There are also
several foods and spices which are known to have hepatoprotective properties.
These include the globe artichoke which can be easily cultivated, both for
their leaves which are used in medicines, and their edible and delicious
hearts. Spices containing hepatoprotective compounds are turmeric, garlic and
black pepper.

Also known as milk thistle and variegated
thistle, it is a common weed of pastures in Eastern Australia as well as in
Europe and North America. It is regarded as the standard amongst
hepatoprotective herbs and remains the most well studied (up to 50 studies and
clinical trials).

Constituents: Flavonolignans. These are unusual
polyphenolic compounds referred to collectively as silymarin.

Actions and use: Early studies conducted by
Vogel and others demonstrated the dual effect of the flavonolignans from
Silybum on the liver, ie. a membrane stabilizing effect (protecting liver cells
from destruction by toxins) via anti-oxidant action, and protein synthesis
enhancing effect, whereby the protected cells act as regeneration centres for
new cells. The studies on silymarin conclusively show its effectiveness in
protecting the liver against a wide range of toxins, from carbon tetrachloride
to ethanol. It even prevents poisoning from the deadly Amanita or death cap
mushroom if administered quickly enough.

Thistle seed preparations are ideal for chronic
and post-acute stages of hepatitis, rapidly bringing an improvement in appetite
and well-being. It is also used in fatty degeneration and even cirrhosis of the
liver. The seeds can be gathered (use gloves!) and made into decoctions, or
ground up and used quite safely as foods. Avoid gathering in areas where
chemical sprays are used.

This is one of the most well known herbs and
universal weed. Dandelion has a long history of use for liver ailments, and its
nutrient content is outstanding. While the leaves tend to act as potent
diuretics it is the roots that are used specifically to promote bile and
restore liver function.

Actions and use: Dandelion is classes as a
choleretic, cholagogue, diuretic and mild laxative. It increases appetite and
improves digestion. Its alkalising effect is beneficial in all detoxification
treatments. The dried roots can be roasted and taken instead of coffee. However
unroasted roots are more therapeutic. They can be taken in decoction form.
Fresh juice of leaves and roots can be taken in 5 ml doses. This is the most
bitter preparation.

Globe artichoke is a popular food originating in
Europe which can be easily cultivated in Australia. It has a long history of
use as a bitter digestive herb and is a major remedy for liver and gall bladder
disorders. It is the leaf that contains these properties.

A safe and reliable herb for all liver
disturbances including hepatitis. Helps lower cholesterol (made in the liver)
and assists weight reduction. It can be made into a leaf decoction and take
alone or in combination with the above two remedies. Artichoke, St.Mary's
thistle and dandelion all belong to the Asteraceae family and work well in
combination.

Schizandra sinensis = Schizandra.

The dried fruits derived from an aromatic, woody
vine that grows in China and north-east Asia. It is a member of the Magnolia
family. The fruits are sour tasting, subsequently stimulating bile production.

Constituents: Lignans known as schizandrins.
Also contains essential oil, fatty oil and mucilage.

Actions and use: Tonic; astringent; sedative;
hepatoprotective.

Studies show it decreases liver enzymes rapidly
in various forms of hepatitis. In mice it protects liver cells from toxins and
viruses, and promotes liver protein synthesis.

Schizandra is beneficial for insomnia, memory
loss and vision impairment. Chinese herbalists make a decoction of the dried
berries, though they are sometimes eaten.

This is a polyphore mushroom known in China as
Ling-Zhi. It is rated as one of the greatest of all medicines, even rivalling
the legendary ginseng. The wild fungus is now hard to find, but extensive
cultivation occurs in many Asian countries so it is readily available though
quite expensive.

Actions and use: Antiviral; antioxidant;
antitumor; immuno-stimulant; hypoglycaemic; cardiotonic; anti-inflammatory.
Hepatoprotective action in mice. Hepatitis patients show improved symptoms and
less tiredness in clinical trials. In China it is frequently used for chronic
hepatitis. It can be obtained in the dried form or in tablets. Daily doses
range between 2 and 10g. This herb should to be taken under the supervision of
a suitably qualified practitioner.

Low shrubs common across southern Asia and
Australia. In parts of India the herb is renowned for its success in treating
hepatitis and jaundice. It has achieved international status since the
publication of a clinical trial with hepatitis B(HVB) patients.

Direct antiviral effects have been demonstrated
in human and animal HVB studies, which could be measured by a reduction in the
virus surface antigen. Several Australian species have also shown antiviral
properties in animal studies on HVB but no clinical data is available. In India
fresh roots are considered the most effective for jaundice. Australian use is
restricted to prescription by medical herbalists.

One of the most widely used herbs throughout the
world, liquorice is regarded by herbalists as a harmoniser or balancing agent.
It certainly improves the flavour of herbal compounds but its properties extend
much further than flavouring.

Chinese teaching hospitals found its effective
rate in treatments of chronic HVB over 70%. The herb has a mineralcorticoid effect
and can cause oedema and hypertension in some people. The popular liquorice
stick candies are of little use therapeutically, since the percentage of
liquorice is small while the sugar content is high. Pure liquorice root can be
obtained in bulk , it has a distinct yellow colour due to its flavonoid
content. Manufacturers use thick liquorice concentrates which are included into
a wide range of products. Liquorice should not be used over long times unless
under supervision of a practitioner.